Registry details
Type
Individual
Primary specialty
Nurse Practitioner, Gerontology
Enumerated
Jun 17, 2008
License(s)
556803 (CA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 4516 MARTIN ST | Union City, CA 94587-5632 | |
| LOCATION | 795 WILLOW RD BUILDING 331, B-WING, OFFICE B-147 | Menlo Park, CA 94025-2539 | 650-493-5000 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.